Fibromyalgia and Fatigue 4 Reasons Why You Flare Up and Get Stuck

One of my readers writes:
"Hey Doc, I’ve got fibromyalgia and have been doing all the right things to improve my fitness. Pacing myself. Accepting my low threshold and working within it with lighter weights and shorter workouts. I’ve progressed, but I’m stuck and not able to increase my exercise tolerance enough. Why is that happening?”
In the video, I dive into some of the reasons why fibromyalgia and chronic pain can be so limiting in terms of activity. Why do you flare up? Sometimes there are things you can do to break through the barrier and build strength, endurance, and ability to function.
Check it out and leave a comment to let me know what you think.
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[@siison1390]

I think unless you’ve experienced fibro you won’t understand the constant pain.

[@drshillermd]

I agree with you 100% that nobody can understand the experience of chronic pain without experiencing chronic pain. But if you're experiencing chronic pain, it's also important to get a birds-eye understanding that is NOT experiential. To understand the big picture of what generates and worsens pain, what causes pain to ripple through your life and cause other medical problems, emotional problems, and functional loss. I hope that my videos and posts begin to provide that.

[@carlsenlifeafter60carlsen11]

I feel the same way. I don’t feel like anybody understands what chronic pain feels like I’m 68. I’m just recovering from my 6 th back surgery . I have fibromyalgia. Also I don’t eat gluten and the foods that causes inflammation. I walk in exercise as much as I can tolerate I am very tired, I used to have an active life and now I don’t. Sometimes I just wish I could talk to somebody that was also in chronic pain.

[@denisewhitlow7493]

Exactly. I can’t stand doctors telling me how doing this and that will help, and when it doesn’t, they don’t believe it’s as bad as it is. My pain is never below a 6/10, no matter what. The 24/7 pain is just torturous.

[@WendyHannan-pt7ez]

Yes I know what you mean, it’s only people with chronic pain and fatigue that truly understand. I’m over worrying what people think, if they visit and I’m laying down, resting because I haven’t slept the night before, too bad, just take me how I am. It’s not being lazy, it’s often just trying to get through another day. On better days I do all I can, but not over do it either. Im just great full I don’t have to work 😉 Take care, we must look after ourselves as best we can. Good luck 😊

[@WendyHannan-pt7ez]

Thank you Dr Andrew, I really enjoyed your video. I’ve liked and subscribed 🙏

[@HobzyMcRuse]

as someone with fibromyalgia, I couldn't agree more.

[@Ann-ws2dj]

I can’t move my body. It feels like my muscles are being pulled away from my bones. It’s like torture.

[@drshillermd]

sounds horrible. sorry that's going on. It can be useful to work on pain sensitivity. I can't give medical advice here. Things that I do with some of my patients, depending on the situation, include: LDN. curcumin, magnesium and b-complex, boswellia, mind-body healing

[@dramatriangle]

@@drshillermd “Most Boswellia grow in harsh, arid regions beset by poverty and conflict,” according to its Wikipedia article. That makes sense that its extracts can help those suffering with fibromyalgia.

[@lindasapiecha2515]

Im constantly in a flare

[@drshillermd]

I'm sorry to hear that. Sounds like your baseline is a very high level of pain and other discomfort. Have you done things to get at the core imbalances that typically drive fibro symptoms? (autonomic, immune, hormonal, sleep, etc)

[@CourteousPublications]

Thanks for this information. I've been dealing with fibromyalgia since 2000, and I am so tired of people telling me that I don't " look sick" although on many days I feel horrible! With that said, I try to isolate and say nothing on those really tough days. I'm glad to hear you say all yoga is not the same. I took one yoga class and I felt awful the next few days. I'm told to exercise because I need to move from having fibro and arthritis. I get on the treadmill and try to do an hour since I no longer work out with a lot of weights. I'm grateful to hear about hormonal as well and to hear about mindful exercises. I will try this out. Thank you.

[@drshillermd]

So glad to hear your open-mindedness! In my experience, that's one of the key mindset pieces that distinguishes people who heal and live good lives despite fibro. If you can believe in your capacity to heal, and smile at the challenges, then you've got a good chance. :-). I invite you to keep learning. I have a few vids here on YT, and also on my blog. this is a good overview of the functional approach: www.drshiller.com/dr-shillers-integrative-approach-to-fibromyalgia/. Your healing path will be unique to you. Wishing you well.

[@claudial1240]

I couldn't agree more, yoga made me feel awful as does even light weight training, the struggle is so real. I find each day completely different but thank you for mentioning this

[@CourteousPublications]

@@claudial1240 You are welcome.

[@teresa.daniel]

Thank you very much for your beautiful explanation Dr. Andre. I'm really tortured by fibromyalgia. I'm suffering for 26 yrs n it's becoming too aggressive. I'm in touch with all good Drs. Im also diagnosed Neuropathy long back but not proper medication was given. Now I'm not able to move myself from any position. Scared to wake up in the morning. Trying to do all kinds of household chores.But unable to do exercises n go for walking due to giddiness. I have various issues. People hardly believe as we look normal. I cannot get up from bed in the morning. With 2mg strong sleeping pill I sleep only at 1or 2am. Ur msg was so consoling. Thank you so much. GBU. 🙌🙌👍👍💐

[@gloriaradivojevic9221]

I love that you actually have medical answers as to why the body is producing these symptoms. I have two questions: is the inflammation caused by fibromyalgia a result of nerve inflammation or more so rheumatoid type of inflammation? And two, could a functional MRI be helpful in identifying what part(s) of the brain are producing pain signals, and if so could it help with finding the best treatment?

[@drshillermd]

Hi and thanks for your comment. I'm not aware of functional MRI being in use anywhere to guide treatment. Some people do quantitative EEG and brain mapping and do therapeutic EEG biofeedback, but I'm not aware of studies showing benefit. Regarding inflammation, I don't think the usual causality assumption of "A causes B" is so relevant in FMS. The way it looks to me from a systems biology point of view is more like "There is synergy and vicious cycles of relationship among Gut dysbiosis and leaky gut, autonomic imbalance, immune imbalance, mitochondrial dysfunction, pain processing, hormonal balance, etc". Trying to pin FMS pain on "nerve inflammation vs rheumatoid type inflammation". I don't know what that means. Whenever there is inflammation, there is neurologic changes. When I hear "Rheumatoid type inflammation" I think of specific body antigens to which the immune system is sensitized, and thus creates autoimmune damage and pain. That kind of inflammation can certain feed the cycle of relationships that leads tot he FMS picture, which is probably why people with autoimmune disease have a much higher incidence of FMS. But you have to also ask, "what is causing the immune system to be sensitized in RA, so that it attacks the body". That's where the systems biology view fits.

[@gloriaradivojevic9221]

@@drshillermd thank you for your reply. It would be really nice to have medical diagnostic tools to identify the cause of Fibromyalgia. It’s difficult to trust or really know what the best approach is to this condition. In my heart I believe it is possible to recover, but it’s challenging to figure out how. I have both CRPS and fibromyalgia. It’s been 14 years, and treatments have been as aggressive as ketamine and lidocaine infusions and radio frequency ablation with minimal success. At least 20 different medications over the years. I won’t even begin to list all the natural treatments, supplements, exercises, diets etc that I’ve tried. The only thing that has had a significant impact has been medical cannabis oil with both CBD and THC. CBD alone did not help. Is that an indication of what part of the brain/body is being affected? Regardless, I want to resume and live a normal life and continuously move past the pain. I walk for hours, been doing some pretty intense renovations, workout and live an active life. However, not sure if pushing through pain and fatigue is hurtful or helpful. I just don’t really care for gentle yoga and Thai Chi, but intellectually I understand why it’s recommended. I think there needs to be a balance between doing something you love, but also something that is helpful. I’m certain that a lot of people living with this condition just want their identity back, but the big question is how? I know that is complex.

[@meredithchildress8001]

Interesting information. I'm so tired of using my body and then being on the couch for a week. Thank you for this video.

[@andrewdavidshiller4158]

Glad it was interesting for you. Sounds like a low threshold of energy production. I hope you're looking into why the system is sick and what you can do about it. Inflammation, dysbiosis, leaky gut, mitochondrial dysfunction, autonomic imbalance. It's a process to heal.

[@davidallison5529]

I like your ideas Doc. I think you're bang-on about mindful relaxing exercise. I'll give that a shot. I have been horizontal for an average of probably 20-22 hours/day for the last 2 years, having had M.E. for 23 years, so suffice to say that 'exercise' for me is not quite what most people would think of as exercise. We have to start from wherever we are. I do see the logic of your approach however. I feel like my parasympathetic system is maybe 10-20% of what it 'should' be. Thanks for the ideas. I appreciate it.

[@drshillermd]

Thanks for your comment and feedback. That’s a hard long road with ME./CFS. I hear that your circumstances are unique indeed

[@davidallison5529]

@@drshillermd Thanks for the reply. I don't believe that my degree of severity is particularly unusual, given the length of time that I have had ME. Actually, factoring in my age (67), I feel like I have done okay, until recently at least. I do believe that many people suffering with this beast just disappear from view, including from further medical attention - hence the name of the patients advocacy group, Missing Millions. I know from my own experience that family & friends wonder why one has disappeared. All they seem able to comprehend is he/she says they have 'some sort of fatigue problem'. The condition is just about impossible to describe to other people. But then, to be fair, I don't know what it is like to have MS, or ALS. That said, I think there is merit to your suggestions, as a different way of understanding the disease and an actionable approach. For some time I have thought that my sypathetic nervous system is maybe 200% of 'normal, while the parasympathetic system feels more like 20%. The idea of 'retraining' these systems in response to activity seems like a possible way forward. I'll see what I can do with that. Anyway, thanks again. It is gratifying to see more M.D.'s evolving their view of M.E. It is a very complicated disease.

[@drshillermd]

@@davidallison5529 Thanks for your thoughtful answer. If you have the sense that you're on "sympathetic overdrive" then it's a good target for self-care and potentially therapeutic approaches. I encourage a broad approach to retraining the autonomic system, via the mind, emotions, and body. There are implications for immune balance and other important determinants of your well being. Please let me know if I can be of support in your efforts. Consider joining my email community as I publish content about these issues from time to time, and also have various training options for people who want to learn. www.drshillerlearn.com/

[@traceywoodbridge3396]

Same as you

[@crystallevin]

I am so sorry that you have been struggling so much with this condition. I felt the same way several years ago. I have had fibromyalgia and chronic fatigue syndrome for about 12 years. I was so frustrated and really discouraged about my life. I kept going back to my doctor and asking for additional help but he didn't know what to do. I prayed and asked God to show me what to do since no one seemed to know what to do to help me. God did show me what the solution was and is. There were other people suffering what I was going through and God showed me some people who had started getting better and feeling better. Short story: Fibromyalgia and Chronic Fatigue are often related so I am going to assume (in my case) that they are a part of the same health issue that I was having. They started at about the same time. I found out that the key to understanding my health issues (where I was in bed most of the time) had to do with my sleep. .....Let me explain. People who have fibromyalgia and chronic fatigue have an underlying auto-immune issue related to certain nutritional deficiencies that prevent restorative sleep. At least this was my situation. These nutritional deficiencies often can't be discovered by simple blood tests because the problem is in the brain stem and not in the body's vitamin and mineral blood levels. Sometimes blood tests can show these deficiencies but sometimes they can't. Here is the protocol I use to feel about 90%. When I wake up in the morning I try to get up about an hour before I really need to eat any food. I take a 3,000 mg packet of liquid liposomal vitamin C. You can find these packets on Amazon. The liposomal vitamin C tablets don't really work as well so you have to take the liquid liposomal vitamin C found in packets. Liposomal vitamin C packets (3000 mg packets) must be taken on an empty stomach so that it absorbs better into the body. These liposomal vitamin C packets boost my immune system and help me feel better overall. After about an hour I eat breakfast and take these supplements 1) 1000 mg of Benfotiamine (Fat soluble vitamin B1). This is the most important supplement that you actually must take to feel better. You can get this reformulated B1 (look for Benfotiamine on Amazon). 1000 mg is a very high dose of B1 but your body is likely very deficient in B1. 2) Next take 5,000 to 10,000 mg vitamin D3. Also take 1 pill of a K2 supplement (the dosage of the K2 does not matter). B1 and D3 are the two supplements that will directly improve your symptoms. You must take high doses of both of these supplements. When I started taking high doses of both of these supplements everything started to change. 3) Take a multi-B supplement in addition to your B1 supplement. Many different B vitamins work together. Make sure your multi-B supplement has 50 mg or less of pantothenic acid. If your supplement has more than 50 mg of pantothenic acid in it, you will not be able to have restful sleep at night. 4) Take a prebiotic and probiotic of your choice. These supplements provide the body with certain types of bacteria that will help the vitamins and minerals work better. If you are frequently constipated also take Tudca. Tudca is a bile salt that helps improve digestion and this one supplement can aid your body in processing and absorbing nutrients. Your digestive system will work better. Drink filtered water during the day (without Chlorine or Fluoride), eat a healthy diet, and avoid foods or medicines that deplete your vitamin B stores in your body (avoid alcohol, tobacco, drugs, sugar, junk food, etc). Eat organic as much as possible. One hour before bedtime take these supplements. 1) Magnesium supplement of your choice (take 2 x the recommended dose on the bottle). Magnesium comes in several different forms so find one that doesn't upset your stomach. 2) Take a zinc supplement (take 2 x the recommended dose on the bottle). 3) Take a food-based iron supplement such as beet root powder. Food based iron supplements generally have much smaller particles of iron than the regular iron supplements found in pill form over-the-counter. This allows the iron to pass through the blood-brain barrier in your body and gives the brain the iron it may be lacking. Blood tests for iron deficiency will not show if there is actually a brain deficiency in iron so taking a food-based iron supplement is important. ...I take a beet root supplement and notice this helps my overall health. It is very noticeable to me. 4) Take a nascent iodine supplement in liquid form. Usually the dosage recommended on the bottle is 1-3 drops. Follow the dosage instructions on the bottle you purchase (found on Amazon). Also try to lower your overall stress and realize that your body needs different things than the average person does. In my mind I often tell myself that my body "Burns through vitamin B1 (Benfotiamine) like a leaky engine burns through oil!" For some reason vitamin B1 (Benfotiamine) , vitamin D3, and magnesium are the only things that seemed to start changing my life-long health problems overnight. More recently I learned that people who have fibromyalgia and chronic fatigue generally have underlying sleep disorders that are hard to assess and eradicate. My sleep has greatly improved since taking these supplements. I sleep more deeply and I have been told that without deep sleep the brain and body are not able to repair themselves properly and so pain, tiredness, fogginess, are the result. This has definitely been my case. I have very little pain or achiness now and my sleep has improved. I feel like I can control my symptoms and I understand my body more now than ever. Most doctors don't understand the underlying causes of these problems. Just a note: You might have an underlying infection. Why do I say this? Because when you don't have restorative sleep because of B1, D3, and magnesium deficiencies, your immune system suffers and your body has a much harder time throwing off viruses and infections. Once you restore your sleep so that your immune system works properly, you may find that you don't have any symptoms of infection. Let me know if this treatment protocol helps you. If you have any other questions about why certain supplements are suggested I can answer more questions. Much Love!

[@gregmalekjonesful]

Low Dose Naltrexone is magical for this chronic pain! Game changer.

[@drshillermd]

so glad to hear it was helpful for you

[@ritaagaba8321]

I tried it but made mine worse!

[@andrewdavidshiller4158]

@@ritaagaba8321 Everyone is different. I've had many people who have felt worse when they tried LDN. It's usually for one of two reasons. 1. They started on a dose that is too high. There are many guidelines about starting people at 1.5mg. In my experience some people are much more sensitive or have adrenal imbalances so they can't tolerate a dose of 1.5mg. 2. They take LDN when they're taking opoiid meds. The LDN blocks the opioid so they feel crummy. 3. some people are sensitive to everything because of immune imbalances. Often a different hypoallergenic filler helps.

[@TacosTina]

Thank you this helped

[@drshillermd]

glad it helped!

[@madhatter909]

thank you for this video

[@starrleo12]

Bingo, you just helped me ,fatty liver and pancreatitis is my cause !Thank you !

[@andrewdavidshiller4158]

So glad it was helpful. And keep in mind that fatty liver and pancreatitis can be connected. Think about the whole digestive system as one interconnected unit. Look for the drivers of inflammation, and think about diet, and nutritional support as potential parts of the solution.

[@starrleo12]

@andrewdavidshiller4158 perfect thank you !I cut out sugars added alot more vegetables !No red meat,no fast food,I also try to walk for 30 minutes a day!Alot of veteran doctors do care about us nor tell us what's going on! I now ask alot of questions and also do my research!

[@caswell96]

Omg I need your help, I have pain & chronic fatigue, IBS, lost appetite, sick issue

[@drshillermd]

sorry to hear you're having such a hard time.

[@xyzllii]

He merely describes what we know. NO INSIGHTS offered here for Fibromyalgia. Just more mansplaining.

[@drshillermd]

Thanks for your comment. It makes me think that either you're hugely more educated than most patients and doctors about fibro, or that you didn't really watch the video. The video shares quite a bit of information that many people don't know. Insights that are rarely shared in the conventional medical context. And I get lots of feedback that this information is extremely helpful for patients. I hear that from hundreds of patients, and from other comments on this video and others. I'm sorry you were unable to gather any insights and felt the need to complain about something that so many other people find helpful. Many people are stuck in a place where they've been told by their doctor that "we don't understand fibro--just deal with it". My view is much different and is supported by considerable underlying research. Applying that research has resulted in many people getting significantly better. A key part of that is understanding the multiple biological imbalances associated with fibro. That includes autonomic imbalance, low-grade inflammation, mitochondrial dysfunction, hormonal imbalance, soft tissue restriction, neuromuscular imbalances and so on. And how when we address them, many people feel significantly better and are able to improve their function. You're invited to learn more, unless you know all that already.

[@xyzllii]

@@drshillermd . Yes...you are quite right...after all these years I do know a fair bit about it. Dr Sarno went into Fibro in great depth back in the day...one of if not the first to do so. What did you add to his and others pioneering work. ?..Dr Sarcasm.

[@drshillermd]

@@xyzllii I didn't write with sarcasm. I'm glad you brought up Dr Sarno. His insights made huge contributions to pain care. But as far as I know, he didn't speak at all about the metabolic, biochemical, immunological, and hormonal aspects of FMS and other related syndromes.

[@simavyas686]

Hello sir im fromidia. Gujrat. Im sufferings from last one year but i try ayurveda. Like nasya. Yoga. Basti. Body massage with sesome oil daily. Heat massages with sea salt. Nd daily 15 minutes my legs keep falling in hot water of kapoor goti. Very much effective bcz in ayurveda this disease is reason for vayu dosha. If possible do this regular basic if possibal only 15 days. U r pain is really gone. Nd possible do ayurveda panchkarma. Or vaman verechan

[@drshillermd]

I'm glad you found ayurveda. There are powerful healing principles and practices there and I hope you have continued healing.

[@simavyas686]

Thx

[@cdracos1]

WANT A GAME CHANGER ??? Have you ever heard of not enough stress ? Stress through various means , can actually use up the energy source away from symptoms until they dissipate !..where your mind and attention goes your energy follows. Use your stress, accept it, embrace it !. Avoidance or resistance = persistence. .

[@drshillermd]

Very well said!

[@stephenstephen1505]

Some good points

[@drshillermd]

Thanks for your feedback

[@RamonaMcKean]

"Meet the edge and soften into it."

[@drshillermd]

That sounds beautiful. Did I say that, or is it your reflection and sharing?

[@RamonaMcKean]

You said it towards the end of the video and I loved it! 8:19 💟@@drshillermd

[@RamonaMcKean]

You actually used the word "soft" a wee bit earlier.

[@fionaestherfortuin4185]

Wow dr thanks for this conformation I do Pilatis stretches I can't do jumping because if spine ops an its amazing how I have energy for the day

[@drshillermd]

I'm so glad you are getting benefit from the pilates and stretching. And glad you respect your boundaries around the jumping. Exercise can be very energizing. Enjoy. 🙂

[@babycoleangel]

Pilates has been God sent to me

[@drshillermd]

@@babycoleangel I'm so glad to hear that pilates has been good for you.

[@dirkkatz172]

culprit: microwaves. it can last 2 years before musclepain goes away

[@kloe89]

Thank you doc❤

[@drshillermd]

You're welcome! Would you care to share what was useful about it for you? (I'm always looking to refine the sharing of info)

[@kloe89]

Doc. Shiller, I am a newly diagnosed Fibromyalgia patient. I'm just trying to educate myself actually. I've been dealing with chronic fatigue, sore joints, body pain, nausea, constipation and the list goes on. I've dealt with depression. I've been misdiagnosed with lupus. It's just hard when love ones thinks you making up all these symptoms in your head. Sighs

[@drshillermd]

@@kloe89 Yeah I heard that about the loved ones. You're not alone in that. "The invisible disease". "Gosh, you look ok, sure it's not in your head?" My patients describe that all the time. Educating yourself is the best thing. There are ways to heal fibro. It's so important to get your head around the Gut-Mindbody-Immune connection and how it also relates to hormones, cellular energy. It's a process. Be patient. Forgive yourself and the people who don't understand. It's not your fault. But you do have an opportunity to transform your life. Feel free to check out some of the other stuff on my blog too.

[@kloe89]

Thank you Doc for all your kind words 🙏. Do have a blessed day 🙏

[@drshillermd]

@@kloe89 you might like this video too www.drshiller.com/ldn-not-a-miracle-cure-for-pain-fatigue-fibromyalgia/

[@sandyclug-qt5wy]

I've had fibromyalgia for 27 years I use aspercreme a lot with lidocaine on the gabapentin seems to help a lot.

[@drshillermd]

so glad to hear that you found something that works for you! 🙂

[@jujuapple6706]

Hmm forr some reason I did not get your notifications.

[@drshillermd]

Hi. Sorry to hear you didn't get the notification. Where did you sign up?

[@jujuapple6706]

@@drshillermd on youtube

[@drshillermd]

@@jujuapple6706 hmm. Does that mean you subscribed, but you didn't get a notification? I don't know anything about how KZbin notifies people. If you want to get notified about new videos, I announce almost all of them through my email list within a week of putting them on YT. You can go to my website at www.drshiller.com and "join the email community" if you like. :-)

[@traceywoodbridge3396]

Great. Thank you. My Proff has me on 15 mins gentle walk twice a day. He includes 1 hour of total quiet time and breathing and learn how to meditate. Everything is gentle exercising. Head shoulder to shoulder to shoulder. Arms stretched in front. Important. If at any point you feel the slightest pain. STOP.

[@drshillermd]

ok. I hope that's going well for you.

[@TacosTina]

Thank you so much! This was so helpful!

[@drshillermd]

Glad it was helpful, Tina. Can you share anything about what was most helpful for you? What else do you need to know?

[@sandyrausch1999]

I did not get them either

[@drshillermd]

which notifications do you mean?

[@sandyrausch1999]

@@drshillermd I cannot remember..

[@MomoSimone22]

The only exercise I like is weights training, so this is depressing 😔

[@drshillermd]

If weight training works for you, by all means keep doing it. I'm not saying its a bad thing, if your body can tolerate it. But if you can't tolerate weight training, and you know that the right kind of exercise might be useful, then you can to decide....do you want to stay rigid in your preferences, or do you want to find what works for you. It's up to you. :-)

[@cdracos1]

Resistance or weight training is my medicine of choice ! Be wary of one size fits all advice. Most fibromyalgia advice comes from those who don't even have it. Would you hire a plumber to sew your wedding dress ?

[@MomoSimone22]

@@cdracos1 Thanks! Yeah, I've been experimenting with the types of weights training I can do without overdoing it. I've cut out big compound exercises for now (i.e., squats, deadlifts), am doing lots of isolation and have cut my workout sessions down to make sure I'm only in the gym for around an hour because I used to spend too long in the gym each session. I have been on uni break for a few months and realised that when I have more work/life balance, my weights training doesn't make me feel as exhausted as when my life is full on busy. I don't think my training will ever be the same, but I definitely think it's something I can keep in my life.

[@WendyHannan-pt7ez]

Would using light weights help ? I know I can’t push myself too hard. I exercise with a senior group, I really enjoy it, but the next day I’m exhausted and can’t do much. Pace is the way to go, but I’m a little all or nothing 😩 Thank you for this video, I enjoyed it.

[@drshillermd]

@@WendyHannan-pt7ez it's super important to find **your** sweet spot. Nobody can predict what your body needs. I can't give medical advice on youtube. But what I tell my patients is to start light and gentle. And build from there. Everyone has a "threshold" above which they overdo it and can we be wiped out for days. For people with fibro the threshold is lower and sometimes the post exercise malaise is worse. So don't worry about anyone else's truth, and find yours. 🙂

[@Dhi-ii3cw]

How long of a break from traditional exercises like running and weights do you recommend? I have been jogging for over a decade to keep my lungs healthy but for the past year it really has made my pain worse. Im trying PT but while it helps, I am still worse the following day.

[@drshillermd]

It's a great question. The answer is very individualized. You need to find out what works for you as an individual. It sounds like you have a background of jogging which is great. And now it sounds like you get pain when you run. First thing is knowing what is the underlying issue. We can't tease it apart in the comments on youtube. But you have to ask what is generating the pain. Is it typical muscle pain/fatiguability like one would have in FMS? Has a qualified doc ruled out other obvious reasons for that? Is there a complicating factor like osteoarthritis of the knees. For someone who has had a full workup and there is no answer besides fibromyalgia, There are two parts to the issue. One optimizing metabolism, biology, immune function and so on, in ways that most conventional docs don't do. Two is doing the right kind of exercise for you. Jogging might not be the right kind, depending on your age, degree of metabolic impairment, and so on. I often recommend "mindful exercise" for people with fibro, because it a. addresses the autonomic balance that often happens, b. more effectively unwinds your tissues and neuromuscular guarding, and c. can help you access a more resourceful state of mind and body. I hope that helps